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Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
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Job Summary
Reporting directly to the Team Supervisor and under the general direction of the Billing & Accounts Receivable Manager, the Billing Representative II performs a variety of billing functions to minimize accounts receivable and enhance collection performance. This position is relied upon to work on any activity within the team with little or no direct supervision. Utilizes electronic billing and medical retrieval systems and in-depth knowledge of medical billing and insurance rules and regulations to resolve accounts receivable issues.
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Qualifications
- Achieve excellence in performance by working collaboratively with others on various teams.
- Supports and demonstrates the values of Massachusetts General Brigham by conducting activities ethically with integrity, honesty, and confidentiality. Demonstrates a positive, open-minded, can-do attitude. Represents a team perspective and willingness and enthusiasm to collaborate with others. Follows through on commitments and achieves desired results. Exhibits sound judgment, obtains the facts, examines options, gains support, and achieves positive outcomes.
- Always maintain high professional conduct standards. Represents the CBPO Professional Billing Office at events and projects external to the organization.
- Ā Ā Enthusiastically promote a cooperative team environment to provide value to all customers. Act as a leader in creating a positive atmosphere within the team. Listen and interact tactfully, diplomatically, and effectively without alienating others.
- Perform all aspects of the Billing Representative I position at a consistently high degree of proficiency. This entails a complete understanding of all department policies and procedures to execute all billing tasks with minimal direct supervision. This representative is expected to be a leader within the team in productivity, teamwork, efficiency, communication, and patient care. Act with minimal supervision, notice or direction to identify and resolve problems and complete work.
- Work the most sensitive Epic Workqueues, projects and/or accounts and provide immediate feedback to Team Supervisor on changes or modifications that need to be communicated to appropriate Liaison/department.
- Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/HIPAA information and report potential impact. Utilize experience and expertise to determine the correct course of action efficiently and effectively on each account/project.
- Effectively handle telephone inquiries from insurance companies and other departments within the PBO. Gather and interpret all relevant information to help resolve issues or complaints. Document issues thoroughly.
- Apply transfers and/or adjustments to invoices as needed to complete each invoice's resolution.
- Request necessary data as appropriate to resolve issue and trends once identified within their work files and follow through on resolutions to completion.
- Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
- Meet deadlines and productivity standards for Epic Workqueues, including but not limited to:
- Insurance verification
- Referral Management
- Correspondence & phone inquiries
- Billing/mailing claims/appeals
- Working claim edits & scrubbers
- Third party follow-up including secondary billing & rejections
- Special projects
- Demonstrate proficiency with a variety of automations, including but not limited to EPIC and PCIS, PATCOM, Microsoft Word, Excel, E-mail, Voicemail and Payor Websites.
- Participate in continuous quality improvement efforts. Establish goals with Team Supervisor and track progress. Comply with hospital confidentiality policy. Manage special projects as assigned.
- Perform other duties as assigned
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Additional Job Details (if applicable)
QUALIFICATIONS:
Detailed working knowledge of medical terminology, ICD 10 coding and CPT, HCPCS preferred
Knowledge, Skills and Abilities
- Strong attention to detail.
- Excellent interpersonal, written and verbal communication skills.
- Proficient in Microsoft Office Excel and other relevant billing software.
- Ability to prioritize and manage multiple tasks simultaneously.
- Ability to work independently and as part of a team.
- Ability to work in a fast-paced environment.
Position is for Point32/Commercial Payer Team within Patient Financial Services.
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Remote Type
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Work Location
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Scheduled Weekly Hours
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Employee Type
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Work Shift
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Pay Range
$19.81 - $28.30/Hourly
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Grade
3
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EEO Statement:
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Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership ālooks likeā by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
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